Minimum opiate prescribing guidelines

CCRMC Minimum guidelines for prescribing controlled substances for chronic (non-cancer) disorders

When starting a controlled substance or continuing a prescription started by someone else, document the following at start or soon thereafter:

• History and physical exam
• Level and location of pain, activity level, other therapies tried
• Personal or family history of mental health and substance abuse
• Pain agreement and informed consent
• Evaluation of risk. A patient may be considered high risk based on any of the following:
  • o ORT, DIRE or COMM risk score
  • o Combinations of controlled substances
  • o Dose of 100mg daily morphine equivalent or above
  • o High concern for recent/active substance abuse

Monitoring:

• Utox yearly
• Re-evaluate risk regularly
• Re-evaluate pain level, substance abuse, activity level and effectiveness of medications regularly
• Follow-up visits q3 months if higher risk or higher dose, q6 months if stable
• CURES yearly strongly recommended
• Strongly recommended to also address sleep and the 4 As (analgesia, activity, adverse effects, aberrant behaviors) at intervals

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This page has been edited 1 times. The last modification was made by - jcc240 on Jan 13, 2015 1:56 pm